Provider Demographics
NPI:1366692691
Name:HEMDAN ABDALLA, ALY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALY
Middle Name:
Last Name:HEMDAN ABDALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 LEWIS AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2121
Mailing Address - Country:US
Mailing Address - Phone:203-238-9446
Mailing Address - Fax:203-238-9447
Practice Address - Street 1:455 LEWIS AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2121
Practice Address - Country:US
Practice Address - Phone:203-238-9446
Practice Address - Fax:203-238-9447
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047705207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease